Modifiable risk factors

可改变的危险因素
  • 文章类型: Journal Article
    目的:假体周围关节感染(PJI)仍然是一种并发症,与高发病率和高医疗费用有关。这篇综述的目的是检查患者和围手术期可改变的危险因素,这些危险因素可以改变以帮助提高PJI的发病率。
    结果:基于证据的文献综述显示,改善术后血糖控制,适当的肥胖管理,营养不良,代谢综合征,术前贫血,戒烟可以帮助降低PJI的风险。此外,使用金黄色葡萄球菌筛查,术前评估维生素D水平,尿路感染筛查,和牙齿卫生检查可以帮助提高PJI的发病率;同样,适当管理围手术期变量,如限制手术室交通,适当的时机,预防性抗生素的选择和手术部位的准备有助于降低PJI的发生率。总之,PJI是全关节置换术的病态并发症。外科医生应警惕可修改的风险因素,这些因素可以改进,以帮助将PJI的风险降至最低。
    OBJECTIVE: Periprosthetic joint infection (PJI) remains a complication that is associated with high morbidity as well as high healthcare expenses. The purpose of this review is to examine patient and perioperative modifiable risk factors that can be altered to help improve rates of PJI.
    RESULTS: Evidence-based review of literature shows that improved control of post-operative glycemia, appropriate management of obesity, malnutrition, metabolic syndrome, preoperative anemia, and smoking cessation can help minimize risk of PJI. Additionally, use of Staphylococcus aureus screening, preoperative evaluation of vitamin D levels, screening for urinary tract infection, and examination of dental hygiene can help with improving rates of PJI; similarly, appropriate management of perioperative variables such as limiting operating room traffic, appropriate timing, and selection of prophylactic antibiotics and surgical site preparation can help to decrease rates of PJI. In summary, PJI is a morbid complication of total joint arthroplasty. Surgeons should be vigilant of modifiable risk factors that can be improved upon to help minimize the risk of PJI.
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